Under Control

Jane* hears her phone alarm ring while sitting with a friend at her house. She grabs it and reads the alert on the screen: “You know what this is,” then jets into the bathroom. She takes out the circular birth control pill dispenser from the cabinet as quietly as she can, pushes a pill from the dispenser and swallows it with a glass of water.

Although Jane has never had sex and went on the birth control pill to relieve symptoms of her menstrual period, she is not comfortable with people knowing that she is taking an oral contraceptive.

“My close friends know, but I feel like there is kind of a stigma about it, because a lot of girls only get it because they are having sex,” Jane said. “I just feel like people will judge that, people who I don’t know.”

Even though the birth control pill was created more than 60 years ago, many students —some of whom take the pill for reasons that have nothing to do with preventing pregnancy — still fear a stigma surrounding the pill and the side effects that it may cause.

In a Chronicle poll collected this weekend, 17 percent of the 267 females polled take the birth control pill, and 56 percent are not comfortable with other people knowing they are on it.

“All of my friends know and my parents totally know,” Taylor* said. “I think everyone understands that I am taking birth control because I have had a boyfriend forever, and I think they would expect me to,” Taylor said.

Seventy-one percent of the female students polled experienced mood swings on the pill, while 52 percent gained weight and 45 percent have gotten acne after using the pill.

Many say they take the birth control pill for the purpose of relieving period symptoms and clearing skin blemishes.

Shari* was told by her dermatologist that she should go on the pill in order to clear her bad acne, but when she went on it, she did not want anybody to know because she was afraid that people would assume she was having sex.

Before she went on the pill, Shari was worried about the various side effects that her friends had experienced.

“The pill basically tricks your body into thinking that it is making a certain amount of whatever hormone is in the pill, usually it is some combination of estrogen and progesterone,” pediatrician Cara Familian Natterson ’88 said. “You essentially don’t cycle through a regular menstrual cycle because your body is at a very stable amount of hormone, so you don’t ovulate, or shed your uterine lining.”

Because the pill causes a woman not to ovulate, she cannot become pregnant.

Natterson said the common side effects of the pill are weight gain and mood swings. However, she does not see these effects as often when prescribing newer versions of the pill, which contain lower doses of hormones. The pill also has positive side effects, such as reducing period symptoms and clearing skin blemishes.

“A lot of adolescent acne is related to hormone swings, and if you are keeping the amount of hormones pretty steady, then your skin should respond by clearing up a little bit,” Natterson said.

Shelly* went on the pill five months ago to relieve her period sympoms, and since then has gained 10 pounds, which she finds very frustrating.

While Shelly does not want to stop taking the birth control pill, she does want to go on a lighter dose because of the drastic impact the prescription has had on her body.

“I don’t really see a need to stop it,” Shelly said. “I do still think it’s worth it for me to be on birth control, but honestly it is forcing me to eat healthier and work out more, because I have realized how much that has an impact on my body, and I now am more conscious about my weight.”

Milly’s* mother was afraid to let her go on the pill to relieve her period symptoms because of the risk of blood clots.

The American Heart Association published guidelines earlier this year recommending that women be screened for high blood pressure before being prescribed oral contraception because it can increase risk of blood clots and strokes.

Natterson said taking the drug creates a high risk of blood clots since it adds hormones to a woman’s body. Natterson said that there is an even greater risk if the woman smokes.

“There is a higher risk of developing blood clots in patients who are predisposed to a genetic factor that causes an increase in the possibility of blood clots with combination hormonal birth control pills,” nurse practitioner Susan Steinrad said. “But nobody tests for those, and there are certain brands of birth control pills that are more contributory than others.”

Milly convinced her mother that she would be a “miserable person” if she did not take the pill.

Nevertheless, Milly has seen some major side effects while taking the oral contraception. Milly accidentally skipped taking the pill one day, and because of that, she got her period for three consecutive weeks.

“I honestly have never been so miserable in my life,” Milly said.

“Your body doesn’t know exactly what is going on,” Steinrad said. “You’re suppressing, you’re not suppressing, you’re suppressing, you’re not suppressing, and you end up having other side effects, and the most common one is breakthrough bleeding, and that is bleeding at times that are not appropriate.”

Along with getting her period for three weeks, Milly also had a lot of breakthrough bleeding, and she became very moody, frequently crying while on the pill. Because of these side effects, Milly stopped taking the pill after three months.

Candy* refuses to go on the pill because she is afraid of the side effects of the pill, such as weight gain and mood swings.

“Even though I’m having sex, I am just using a condom,” Candy said. “I am so terrified of getting those side effects, and I have heard so many stories about my friends on the pill, so I refuse to go on it.”

Taylor has also had some side effects after taking the pill, but they have not been as drastic. She has seen her thighs get a little chubbier, and her breasts a little larger, but she says that the side effects are minor for her, and she would not stop taking the birth control pill because of them.

Taylor is, however, considering using a different method of birth control, the Intrauterine Device, or IUD.

The American Academy of Pediatrics says that the first choice for contraception should be a longer-term device, such as an IUD.

The IUD prevents a fertilized egg from implanting in the uterus. Depending on the device, some stop the menstrual cycle while others do not, Natterson said.

“The reason why the American Academy of Pediatrics recommends this is that people forget to take medicine, all the time, and that’s not just teenagers, it’s everyone, but teenagers in particular,” Natterson said.

Natterson prescribes different forms of birth control depending on the patient’s background.

“It really depends upon the kid and what they are coming in for and what their personality is like, what their concerns are,” Natterson said. “Are their parents involved in the choice? That’s a big deal. It’s a complicated recommendation.”

Steinrad also says that IUDs are a little more difficult to insert in younger women who have not given birth, although it is possible to do. She also emphasizes that neither birth control pills nor IUDs protect against sexually transmitted diseases.

Some girls say that once they are on the pill, they are inconsistent with condom use.

“Now I’m on antibiotics and my doctor said they limit the pill so I’ve used a condom,” Taylor said. “But when I wasn’t on it sometimes, I didn’t use one.”